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P. 1
Format Pengkajian Kdm

Format Pengkajian Kdm

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Published by Nira Primagiani

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Published by: Nira Primagiani on Jun 20, 2012
Copyright:Attribution Non-commercial

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09/22/2013

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A.
 
PENGKAJIANTanggal : .....................................Jam :......................................
1.
 
Identitasa.
 
Identitas Klien
Nama : ..............................................................................Umur : ..............................................................................Jenis Kelamin : ..............................................................................Pekerjaan : ..............................................................................Alamat : ..............................................................................No Reg/no CM : ..............................................................................Diagnosa Medis : ..............................................................................
Identitas Penanggung Jawab
Nama : ..............................................................................Umur : ..............................................................................Jenis Kelamin : ..............................................................................Pekerjaan : ..............................................................................Hubungan Dengan Klien : ..............................................................................Alamat : ..............................................................................
2.
 
Riwayat Kesehatana.
 
Keluhan utamab.
 
Riwayat Penyakit Sekarang
 
 
c.
 
Riwayat Penyakit Dahulud.
 
Riwayat Penyakit Keluargae.
 
Riwayat Alergi
 
3.
 
Pola Kesehatan Fungsionala.
 
Pemeliharaan Kesehatan
b.
 
Nutrisi Metabolik
 No Kegiatan Di Rumah Di Rumah Sakit1. Pola MakanFrekuensiJenisPorsiPantanganDiet KhususMakanan yangdisukaiNafsu makanKesulitan menelanGigi palsuNGT2.Pola MinumFrekuensiJenisJumlahPantanganMinuman yangdisukai

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